NEW YORK —
A study suggests vitamin E supplements might be good for some Alzheimer’s patients. The benefit was not huge, but for a devastating disease that has proved almost impervious to treatment, it was notable.
The study, in Wednesday’s issue of JAMA, The Journal of the American Medical Association, found that over a little more than two years, high-dose vitamin E slowed the decline of people with mild to moderate Alzheimer’s by about six months on average.
Vitamin E did not delay cognitive or memory deterioration. Instead, it seemed to temporarily protect something many patients consider especially valuable: their ability to perform daily activities like putting on clothes and feeding themselves.
Compared with other study participants, people who took vitamin E required about two fewer hours of help per day, the researchers said.
“Is it really going to dramatically alter the lives of Alzheimer’s patients? That’s unclear,” said Dr. Scott Small, director of Columbia University’s Alzheimer’s Disease Research Center, who was not involved in the study. “But it might improve patients’ ability to bathe themselves and dress themselves.”
Notably, in this study, high-dose vitamin E appeared safe. Doctors had stopped suggesting it to Alzheimer’s patients after a 2005 analysis suggested that high doses could increase the risk of mortality. That analysis looked at vitamin E’s effect on patients with various diseases, not just Alzheimer’s.
“We were concerned about safety, and we didn’t find a safety problem,” said Dr. Maurice Dysken, a professor of psychiatry at the University of Minnesota, who led the new study.
Still, specialists, including the authors, said the new study did not mean that high-dose vitamin E should be taken by everyone with dementia or everyone hoping to prevent it. The study found benefit only in people with mild to moderate Alzheimer’s, a result that echoes research in 1997 showing that vitamin E could delay functional decline for about seven months in people with moderately severe Alzheimer’s.
But other studies have found that vitamin E failed to delay dementia in people without symptoms or with mild cognitive impairment, which can precede Alzheimer’s.
“It was dead stone cold in the MCI trial,” said that study leader, Ronald Petersen, of the Mayo Clinic’s Alzheimer’s center. “You couldn’t have found a closer match to placebo.”
Dr. Denis Evans, a professor of internal medicine at Rush University, who wrote an editorial for the new study, cautioned against extrapolating the results to anyone without mild to moderate Alzheimer’s.
“Does this mean that all of us who don’t want to develop Alzheimer’s should rush out and purchase a bottle?” he said. “Oh, please don’t.”
The study involved 613 veterans, mostly men, from 14 Department of Veterans Affairs hospitals around the country. The veterans were taking drugs like Aricept for mild to moderate Alzheimer’s. One group received 2,000 IUs of vitamin E daily, much higher than the amount available in a typical supplement. Other groups received memantine (a dementia drug used in medications like Namenda), vitamin E plus memantine or a placebo.
“What we hoped was that memantine would have benefit, vitamin E would have benefit, and combined it would have double the effect,” Dysken said. That did not happen.
Only vitamin E showed a statistically significant effect. Memantine was no better than the placebo at preventing decline, and, inexplicably, the combination of memantine and vitamin E did not work either.
There were other confusing results. While vitamin E helped people perform daily functions longer, it did not significantly slow their cognitive decline.
“That they found differences in functional measures and not the cognitive measure gives you pause,” Petersen said.
Functional abilities decline for a wide variety of reasons related to aging, not necessarily to Alzheimer’s, Evans noted. Most specialists say a truly effective Alzheimer’s treatment will improve both function and cognition.
Evans and others said doctors should now consider discussing vitamin E supplements with patients with mild to moderate Alzheimer’s disease.
But, Evans said, “2,000 IUs is a lot, and I wouldn’t recommend it unless there’s some oversight” by a doctor.
Petersen said he might mentionvitamin E after trying other treatments.
“ It’s not a home run,” he said. “ It gives doctors and patients another option to use as the disease progresses.”